TRALI risk

Q: Which of the following organ transplant carries the higher risk of Transfusion Related Acute Lung Injury (TRALI)? (select one)

A) Liver 

B) Kidney

Answer: A

A whole list of risk factors has been identified for TRALI. Some of the major risk factors include (but are not limited to ) the following:

• Recent surgery (particularly cardiac)
• Cytokine treatment
• Massive blood transfusion
• Active infection (Sepsis/SIRS)
• Low levels of the anti-inflammatory cytokine interleukin-10 (IL-10) 
• High C-reactive protein (CRP) 
• Liver transplant surgery
• Chronic alcohol abuse
• Shock
• Higher peak airway pressure while being mechanically ventilated
• Current smoking
• Higher interleukin (IL)-8 levels
• Positive fluid balance
• Hematologic malignancy
• A high Acute Physiology and Chronic Health Evaluation II (APACHE II) score 
• Recipients of platelet or plasma-containing products
• Female gender

#hematology

References:

1. Toy P, Gajic O, Bacchetti P, et al. Transfusion-related acute lung injury: incidence and risk factors. Blood 2012; 119:1757.

2. Vlaar AP, Binnekade JM, Prins D, et al. Risk factors and outcome of transfusion-related acute lung injury in the critically ill: a nested case-control study. Crit Care Med 2010; 38:771.

3. Menis M, Anderson SA, Forshee RA, et al. Transfusion-related acute lung injury and potential risk factors among the inpatient US elderly as recorded in Medicare claims data, during 2007 through 2011. Transfusion 2014; 54:2182.

4. Toy P, Looney MR, Popovsky M, et al. Transfusion-related Acute Lung Injury: 36 Years of Progress (1985-2021). Ann Am Thorac Soc 2022; 19:705.